Mifepristone for treatment of uterine leiomyoma. A prospective randomized placebo controlled trial

Abstract

Mifepristone may offer an effective treatment option for women with uterine leiomyoma and the associated pronounced uterovaginal bleeding. Clinical Trials identifier: www.clinicaltrials.gov: NCT00579475.

Medical Treatment of Fibroid to Decrease Rate of Hysterectomy

“…One potential link between the effects of the two key steroid hormones on ULMs is that estradiol induced the expression of the progesterone receptor and supported progesterone action on leiomyoma tissue [48]. Clinical findings also support these laboratory observations; studies have involved the evaluation of mifepristone (RU 486) [50][51][52], azoprisnil [43,49], and more recently, CDB-2914 and CDB-4124 (CDB: Contraceptive Development Branch) [53].…”

A Comparative Study Between Preoperative Use of Misoprostol and Dinoprostone for Reduction of Hemorrhage During Abdominal Myomectomy.

“…Engman et al (19) compared 49 women who received 400 μg of rectal misoprostol 1 h before having laparoscopic-assisted vaginal hysterectomy (LAVH) for leiomyoma with 68 women who did not. They found no significant difference in blood loss between the two groups.…”

Medical Management of leipmyomas-emphasis for different geographical regions

“…GnRH and RU486 therapies often cause UL regression possibly by enhancing cellular apoptosis [25,26] . Although initially it was used in low doses by Fiscella et al, a dose of 50mg alternate day was found to be more effective for greater reduction of myoma as well as uterine volume by RU486 [27,28] . Further Engman et al studied Glutathione-s transferase mu1 (GSTM1) gene pathway as a biomarker for which patients would be good responders to mifepristone, or poor responders with those having high expression of GSTM1 as good responders and this can be used to predict the leiomyoma volume regression in response to mifepristone treatment [29] .…”